This is a class action filed in the Western District of Missouri, in which the plaintiffs are seeking to prevent the state from disenrolling recipients in Missouri's State Children's Health Insurance Program (SCHIP) who fail to meet their premium requirements without first notifying them of their right to appeal and to continue to receive program benefits pending the outcome of the appeal. The defendants are the Missouri Department of Social Services, and the interim directors of the state Family Support Division and the state Division of Medical Services. According to the named plaintiff, Julia M., Missouri terminated the benefits of her minor child, when, after a series of bank errors, the monthly premium was not deducted from Julia M.'s account in a timely fashion. Julie M. received the notice after the benefits already had been terminated. While the notice indicated a right to appeal, it did not indicate a right to continue benefits pending the outcome of the appeal or that the state had conducted any evaluation to determine eligibility for other benefits.

On June 25, 2007, the District Court (Judge Nanette K. Laughrey) certified the class, defining it as "[a]ll children residing in Missouri and who are receiving or who will receive [Missouri SCHIP] health coverage and are required to pay a premium under [state law]."

Judge Laughrey, however, did not immediately rule on the request of the representative plaintiff, identified as Julia M., to issue a preliminary injunction requiring the Missouri Department of Social Services to provide recipients with sufficient notice of disenrollment and continued benefits pending any appeal.

On February 2, 2008, the parties signed a Consent Decree in which the Defendants agreed to notify participants in SCHIP who have fallen behind in their payments. The notification must tell the participant that he/she has a right to appeal, and that during the appeals process he/she is entitled to continued benefits until the matter is resolved. Defendants also agreed to pay the plaintiffs over $165,000 in attorneys fees and expenses.

The Court was to retain jurisdiction until October 15, 2008 in order to monitor the execution of the Consent Decree.

Joshua Arocho - 06/26/2012


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